allergy

Attract and Retain Allergy Patients

By following these strategies, both the ocular allergy and pathology portions of your practice may thrive.

JENNIFER KIRBY, senior associate editor

Ocular allergies affect more than 20% of Americans.1 In addition, 40% of U.S. adults reported the occurrence of watery, itchy eyes throughout one year, according to the U.S. Third National Health and Nutrition Examination Survey (NHANES III).2 Also, in a study of hay-fever patients, conjunctivitis symptoms were at least as severe as rhinitis symptoms in 70% of patients.3 Further, about 50% of those who have nasal allergies reported their ocular symptoms (itchy, red, watery eyes) were moderately to very troublesome, and 10% of these people said red, itching eyes were the most distressing part of their allergies, according to HealthSTAR Communications' Allergies in America: A Landmark Survey of Nasal Allergy Sufferers, Executive Summary.

Because these statistics indicate that ocular-allergy patients are nothing to sneeze at, you should actively attract and retain these patients. Here are two tips from your colleagues on how you can do this.

1. Educate current and potential patients

Unfortunately, many of your patients seek their primary-care doctors for their ocular issues because they don't realize your skills surpass refraction. To change this thought process and attract and retain allergy patients, you must actively educate both current and potential patients about your ability to treat their ocular allergies. You can accomplish this by following these internal and external marketing methods.

The internal marketing methods:

► Include educational materials in your reception room. Optometrist Bobby J. Christensen, of Midwest City, Okla., suggests you adorn your reception area with point-of-purchase (POP) materials, such as posters, pamphlets and counter cards, that describe in detail the signs and symptoms of ocular allergy.

"These items educate the patient in two ways: They let him know whether he, a friend or family member may be suffering from ocular allergies, and they send the message that you have the ability to prescribe medications that may alleviate the symptoms of ocular allergy," he says.

Optometrist Ernie Bowling, an associate professor at the University of Alabama at Birmingham School of Optometry, who recently retired from 17 years of private practice, recommends you install an electronic news ticker board in your reception room.

Common Medication Scenarios

Many primary-care doctors who have diagnosed their patients with allergies prescribe a systemic anti-histamine that may not quell their patient's ocular allergy symptoms, Dr. Bloomenstein says.
"By educating patients about this fact and discussing ocularallergy medications that can provide relief, these patients will be sure and see you from now on because they'll view you as the eyecare expert," he says.

Many patients self-prescribe, using OTC products that often require instillation every two to four hours to achieve continuous relief, and may induce toxic side effects, such as preservative-related damage to their ocular surface, Dr. Bloomenstein says.
"When you educate patients about these risks and offer easier-to-use and safer prescription medications, these patients will stick with you for their eye care," he says.

Some patients present saying their primary-care doctor diagnosed them with pink eye, but that the anti-infective drop he prescribed isn't providing relief, Dr. Gradowski says.
"When this happens, I conduct a thorough anterior-segment exam via slit lamp — something non-eye doctors typically don't have — and discover these patients actually have giant papillary conjunctivitis (GPC)," he says. "Because their primary-care doctor doesn't have this device or an extensive knowledge in this form of ocular allergy, these patients then see me exclusively for all their eyecare needs."

"I programmed my practice's board to read: 'Are your eyes itching and burning? If you answered yes, you may have ocular allergies,' " he explains. "As a result of this board, many patients said, 'Gee Dr. Bowling, I know I'm here for my annual eye exam, but I was reading the ticker in your reception room about allergies, and I think that might be me. Can you see whether this is the case?'"

Optometrist John Schachet, of Englewood, Colo., says his 3-D animation and illustration software, located both in his reception and exam rooms, has prompted many of his patients to inquire about ocular allergy.

"I think the reason this software has been so successful in garnering me potential ocular-allergy patients is that it not only educates patients on the causes, signs and symptoms of ocular allergies, but shows them the impact ocular allergies have on their eye health," he says.

► Use your staff. Your staff members are the first contact patients have with your practice. This means that a patient's impression of a staff member translates to their impression of you. Therefore, it's imperative your staff know what you treat and have a basic knowledge of ocular conditions, such as allergy, Dr. Schachet says.

"They're [staff] the ones who get the telephone calls and see the patient before you do in the pre-testing area, so you must prepare them with answers to the questions patients may ask," he says. "A staff's uncertainty can and often times will translate to an uncertainty in your abilities. I educate my staff on the latest treatments and diagnostic devices at periodic staff meetings."

► Personally educate. Having educational materials in your reception room and an educated staff definitely helps with patient education, but you play the key role in identifying these patients. This is because the symptoms of allergies, unlike other ocular conditions, such as cataracts, are often intermittent, Glenn S. Corbin, O.D., of Reading, Pa. says. As a result, many undiagnosed ocular-allergy patients assume their symptoms are normal.

"If a patient presents for his annual eye exam one week after a three-day stint of itchy, watery eyes, he's not going to read your allergy educational materials because he's already forgotten about this experience," he says. "This is also why he may not mention it to your staff person during pre-testing questioning, or answer "yes" to an ocular-allergy question on your patient-history form."

The best way to educate allergy patients: Personally ask the patient yourself, 'do you ever throughout the course of the year suffer from periods of itching, redness, tearing or lid swelling?,'" Dr. Corbin says. "The key here is the phrase 'throughout the course of the year,' because it makes the patient really think back to any time he may have experienced these symptoms."

Optometrist William Townsend, of Amarillo Canyon, Texas, adds, "We're fairly good at asking about ocular allergy in the spring and fall, but we need to remember that many people suffer from perennial allergy and therefore have these problems, which they don't realize are allergy-related, on a chronic basis," he says.

The other question to ask: Are you currently taking any prescription or over-the-counter (OTC) medications for these symptoms, and are they providing you relief? "This question is important because many patients aren't aware optometrists have prescription rights or the expertise to prescribe the most appropriate treatment, until you personally educate them of these facts," Dr. Corbin says.

"Patient education through personal proper questioning lets them know that ocular allergies are serious, that eye care is your expertise, not their primary-care physician's, and that you can prescribe medications to improve their quality of life," Dr. Corbin says. "This binds these patients to your practice, ensuring they'll seek your services in the future and refer others." (See "Common Medication Scenarios")

► Request follow-up appointments. When you request a patient return so you can assess the effectiveness of your prescribed treatment, it creates patient loyalty and generates referrals, Dr. Schachet says.

"This is because it let's the patient know that you genuinely care about ensuring his ocular symptoms subside," he says.

► Have an on-hold message. Dr. Christensen suggests you place an on-hold message on your phone system that reminds current patients and educates potential ones that ocular allergy is something you treat.

► Have a practice Web site. Because several current and potential patients use the Internet to obtain information on health care, it's essential you have a practice Web site that lists the services you provide, Dr. Christensen says.

"We have a primary-care optometric practice, so we list all the services we provide under that umbrella, including ocular allergy," he says. "Each month, we spotlight an ocular condition and describe the ways in which we can treat it. We usually spotlight allergy during a spring month, as we've found this is when our patients begin to exhibit symptoms."

"We tag the records of our ocular-allergy patients, and we're in the process of asking them whether they wouldn't mind giving us their e-mails," he says. "We believe disseminating the most-up-to-date information on ocular allergy will benefit them, should they feel a new medication may improve their quality of life, and us, should they decide to present for an appointment, so we can make that determination."

► Send newsletters. Dr. Corbin suggests sending newsletters or electronic newsletters (by e-mail) that include an overview of ocular allergies and call attention to the fact that patients may be overlooking and/or needlessly living with the symptoms of ocular allergy.

"The newsletter should also reveal that you have the ability to help these patients via various treatment options, many of which are easier, safer and far more clinically effective than the OTC medications many of them may be relying on," he says.

► Join a local club or clubs. Joining a club or clubs in your area is an excellent way of attracting and retaining new patients, as your fellow club members will ask what you do for a living and then think of you for their eye care in the future, Dr. Christensen says. His one caveat: Have a genuine interest in the club or clubs you choose to join.

"Your fellow club members will want to know what, specifically, made you join, and if your answer has nothing to do with a genuine interest in the club's purpose, you'll not only alienate your fellow club members, but their friends and family," he says. "No one likes to be used."

You can garner referrals from other healthcare practitioners in your area by taking them to lunch and explaining your abilities as an O.D. and how those abilities could benefit their patients.

► Seek speaking engagements. Dr. Bowling recommends you include a question on your patienthistory form that asks, "Do you belong to any club or organization that you feel would benefit from a speaking engagement on eye care, such as allergies? If so, what is the name of your organization, and to whom shall I speak to set up this speaking engagement?"

"A lot of times, these organizations are very receptive to having you speak because they're struggling to find speakers," he says. "Don't charge for these local speaking engagements, as you'll receive compensation via new patients."

► Use the local media. Optometrist Marc Bloomenstein, of Phoenix, suggests you use the local media to promote the fact that you treat ocular allergy.

"Allergy is a very hot topic because it affects such a large number of people. So, send a letter to the programming director of your local affiliate, which you can find by calling the station, letting him know you're interested in educating their viewers on ocular allergies," he says. "Or, call the editor of your local newspaper, and let him know you'd like to contribute an article on ocular allergy. I've actually had patients who've called to schedule appointments based on articles I've written for the local newspaper."

2. Make contact with other healthcare providers

Another way you can attract and retain allergy patients is to make contact with other healthcare providers in your neighborhood, your colleagues say.

"When I first started my practice, I'd choose a physician from a certain specialty, such as primary-care, every week and invite that person to lunch, so I could explain my abilities as an optometrist and how those abilities could benefit their patients," Dr. Schachet explains. "As a result of these lunches, many of these practitioners ended up referring their patients to me for ocular-allergy evaluations, among other eyecare needs."

Dr. Gradowski adds, "Allergists and primary-care physicians typically don't have slit lamps, among other equipment to allow them to make a differential diagnosis. It's up to you to make them aware that you do have this equipment and the expertise to use it to provide a definitive diagnosis."

Dr. Bloomenstein recommends you write letters to the healthcare practitioners in your neighborhood.

"If you've treated a non-practitioner-referred patient, send his primary-care doctor a letter explaining how you were able to help their patient," he says. "This is an excellent practicebuilder, as if a patient with similar issues should present to that practitioner, he may be inclined to recommend that patient see you. I've personally found this to be the case in many instances."

Many practitioners scoff at the idea of actively attracting and retaining ocular-allergy patients because they don't believe they'll get enough of a financial return to make their efforts worthwhile, Dr. Corbin says.

"It's true that ocular allergy in and of itself isn't going to garner you as much revenue as treating other ocular pathology, such as glaucoma and AMD," he says. "But, if you can show your ocular-allergy patients that you have the ability and expertise to prescribe medications that will alleviate their symptoms, they'll become loyal to you, which means they'll not only exclusively seek your care when they develop other ocular issues, but they'll refer others to you as well. What some practitioners seem to forget is that these other issues may include glaucoma and AMD." OM